Quy Tran

Pancreatic cancer is a common gastrointestinal malignancy with a poor prognosis. The primary goal for caregivers is effective palliative care, especially pain control, which is routinely managed by administration of narcotic analgesics. An alternative or adjunctive modality is celiac plexus neurolysis (CPN), a safe and effective procedure. Recent advances in the use of endoscopic ultrasonography (EUS) have made it an attractive guidance technique for CPN while allowing for a simultaneous tissue diagnosis. We report our experience using EUS-guided CPN and review the available literature regarding this modality.

The hepatoprotective effect of majonoside R 2 (MR2), the major saponin constituent from Vietnamese ginseng ( Panax vietnamensis, Araliaceae), was evaluated in vivo on D-galactosamine ( D-GalN)/lipopolysaccharide (LPS)-induced hepatic apoptosis and subsequent liver failure in mice. Pretreatment of mice with MR2 (50 or 10 mg/kg, intraperitoneal) at 12 and 1 h before D-GalN/LPS injection significantly inhibited apoptosis and suppressed following hepatic necrosis. Importantly, the elevation of serum tumor necrosis factor-alpha (TNF-alpha) level, an important mediator for apoptosis in this model, was significantly inhibited by MR2 at a dose of 50 mg/kg. On the other hand, MR2 was found to protect primary cultured mouse hepatocytes from cell death by inhibiting apoptosis induced by D-GalN/TNF-alpha in vitro, as evidenced by DNA fragmentation analysis. These findings suggested that MR2 may have protected the hepatocytes from apoptosis via an inhibition of TNF-alpha production by activated macrophages and a direct inhibition of apoptosis induced by TNF-alpha.